Monday Morning Musings

The adage, "Damned if you do and damned if you don't" is most appropriate when thinking about the controversy over the recent prisoner swap in Afghanistan for Army Sgt. Bowe Bergdahl. In an article in The Atlantic, David Rhode gave his perspective, having been a prisoner in Afghanistan at one point, too. The bottom line is that the choices are hard to make. Do you pay a ransom? Or, as in the case of Bergdahl, make an unbalanced trade that gives too much to the enemy.

I liked what President Obama had to say in response to the criticism he's received on this issue. "American people understand that this is somebody's child and that we don't condition whether or not we make the effort to try to get them back."

Did you watch the Tony Awards Show last night? I thought Hugh Jackman did a great job as host, and I loved the ending where he invited everyone onstage to sing the theatre classics "The Lullaby of Broadway" and "New York, New York". It was also a thrill to see Audra McDonald win her 6th Tony for her role as Billie Holiday in "Lady Day at Emerson's Bar & Grill".

A little while ago I took a break from writing the blog to eat breakfast, and I always read while I am eating. This morning, I found an interesting line in Laura Lippman's novel Life Sentences. Cassandra, the central character is thinking about all the hurtful things that people say to and about each other and this thought crosses her mind, "Say the worst things about yourself first, and no one can ever hurt you."

That brought to mind people that I have known who seem compelled to say self-deprecating things about themselves. That works well in comedy, but I think it is a little sad in real life. What do you think?

I have a busy week ahead with rehearsals for our Nite of Comedy two nights, and two nights of speaking engagements. One is tonight, so I need to finish preparing the handouts. What is on your agenda for the week?

Finally, I'll close with a joke from The Laugh Factory
Little Billy came home from school to see the family's pet rooster dead in the front yard. Rigor mortis had set in, and it was flat on its back with its legs in the air. When his Dad came home, Billy told him, "Dad, our rooster is dead and his legs are sticking in the air. Why are his legs like that?"

His father, thinking quickly, said, "Son, that's so God can reach down from the clouds and lift the rooster straight up to heaven."

"Gee Dad, that's great," said little Billy. A few days later, when Dad came home from work, Billy rushed out to meet him yelling, "Dad! Dad, we almost lost Mom today!"

"What do you mean?" asked his father.

"Well Dad, I got home from school early today and went up to your bedroom and there was Mom, flat on her back with her legs in the air, screaming, 'Jesus, I'm coming! I'm coming!' If it hadn't of been for Uncle George holding her down, we'd have lost her for sure!"

Friday's Odds and Ends

A recent story in the Dallas Morning News reported that the reservoirs serving the Dallas-area are 10% lower than a year ago and the continuing drought does not indicate that it's going to get any better. The area is more than 30 inches shy of normal rainfall over the last six years, yet nobody has taken really serious action toward a long-term solution to the water problem, other than looking at ways to bring in more water - pulling from East Texas reservoirs for one.

People still pour gallons and gallons of water on landscaping and lawns every year, in many cases trying to maintain greenery that was not meant to grow in this hot climate. Perhaps people should think more about whether their grandchildren or great-grandchildren might have a glass of water in their future instead of wanting the most luxurious green lawn today.

Jonathan Rauch, contributing editor to The Atlantic, wrote an interesting article about health care for the very elderly who too often end up in intensive care units at hospitals for the last weeks or days of their lives. He believes that is an unnecessary and extraordinary use of healthcare facilities and money. He wrote, "Hospitals are fine for people needing acute treatments, like heart surgery, but they are very often terrible place for the frail elderly."

The article was promoting the idea of home-based primary care, and to highlight the benefits of that approach, Rauch mentioned a program called Advanced Illness Management at Sutter Health, a giant network of hospitals and doctors in Northern California. Brad Stuart has worked there for the past 15 years, developing home-based care for frail, elderly patients, and he estimates that using that type of program and keeping patients out of the hospital saves Medicare upwards of $2000 a month on each patient, maybe more. "For years, many people in medicine have understood that late-life care for the chronically sick is not only expensive, but also, much too often, ineffective and inhumane."

Because Medicare is not set up to work with this type of program, that is one of the reasons that home-based medical care is not widely used across the country. The layers and layers of rules and requirements and policies for using Medicare seem to be cast in stone and don't leave room for a doctor or a patient or a hospital to figure out a more cost-effective way to handle a medical issue. For example,   there were people in the extended care unit of a hospital at which I worked who were receiving 6 to 8 weeks of IV antibiotics. I don't recall the exact cost of daily hospital stay, but it certainly was a lot more than had these people been allowed to go home with a visiting nurse coming in every day to administer the antibiotic, check the IV port to make sure it was working properly, and tend to any other medical needs the patient might have.

One time, two gentlemen who were stuck in this extended care unit decided that they would use that time to appeal to the government to rethink policy. They gathered statistics from the medical social worker on cost comparisons and then wrote letters to political leaders, starting at the state level and going all the way to Washington. The letters, with all the statistics and a recommendation to change the policy, were also sent to the people who manage and administrate Medicare. The responses that they receive back were often just a form letter that simply stated "We are sorry that our program does not allow for this type of in-home healthcare that you are requesting."

Nobody seemed to be able to look at this idea and say, "Hmmm, maybe we should figure out a way to implement this cost-saving measure and save the taxpayers a whole lot of money."

I know, I know. Government bureaucrats don't seem to understand simple and efficient. And from all outward appearances, they don't seem eager to figure it out.

Isn't this a better setting than a hospital? Photo courtesy of My Elder Advocate

It's been a while since I've done Literary Lessons, and this is a good one from Tennessee Williams' classic play "Cat on a Hot Tin Roof." The line belongs to Big Daddy, "Ignorance of mortality is a comfort. Men don't have that comfort, he's the only living thing that conceives of death, that knows what it is, the others go without knowing. A pig squeals, but a man, sometimes you can keep a tight mouth about it."

That's kind of depressing, so let's end on a joke.

"How is it that we put man on the moon before we figured out it would be a good idea to put wheels on luggage?"

Monday Morning Musings

Well, I missed posting a book review yesterday. I decided to take most of the day off from anything online, and that felt good. I think we do need to disconnect sometimes. I went out to lunch with my hubby, and then we watched TV shows we'd taped, and I finished the jigsaw puzzle I'd been working on.

I've seen two of the birds, cardinal and bluebird, already this spring.

Last week, Dallas Morning News columnist Jacquielynn Floyd wrote about the recent decision by the  Transportation Security Administration to allow small knives and other sharp implements on airplanes. There has been quite a backlash since the decision was announced a few weeks ago, with many people saying it is a dangerous move.

Floyd asks us to look at the decision with reason instead of emotion. We all still have strong emotional reactions to what happened on 9/11, and many people are anxious and fearful when they are flying, worried that their plane could be hijacked the way the terrorists took over the planes that fateful day. Floyd quotes James Fallows, a correspondent for The Atlantic, who has written extensively about flight safety. He contends that "reinforced coskpits and alert passengers make it impossible for a handful of terrorists with small weapons to hijack or crash a plane."

Patrick Smith, a commercial pilot agrees. He has written in his column for the Boston Globe that the 9/11 terrorists plan "relied almost entirely on the element of surprise, not weapons," and that surprise was a one time event." He believes that hijackers will never be able to take over an airplane with small knives again.

Whether or not we agree with those opinions, I think we should agree that we should bring more reason to the discussion, or any discussion, and not always act on an emotional knee-jerk reaction.

And now for a bit of fun. In the comic strip One Big Happy, Ellen, Ruthie's mother, is helping her with homework.

Ellen: "What type of sentence is each of the following - telling or question? Is that a banana?"

Ruthie: "That's easy. It's a question! And a dumb one! What else could it be? An Avacado?"

So what did you do this weekend? Anything more interesting than a jigsaw puzzle?